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It started when she was barely seven. Madiha belonged to a loving middle-class family but her outwardly happy existence was marred by the ugly secret that she was being molested for years by her elder male cousin. By the time she realised what was being done to her she didn’t know how to get out of it.

Torn from within, she finally mustered up the courage to reveal her distress to her stunned mother. After some cat and mouse games with the abuser, the abuse stopped and, like with so many other children, the issue was brushed under the carpet. Her mother buried her head in the sand and pretended it never happened. She received no counselling.

Years later, Madiha is happily married, yet this blemish from her past lurks in the corner of her mind, vowing never to die.

What do such children do? Where do they go? Either they cope on their own or their families help them move on. Those who seek professional counselling are a handful.

Psychologist Mariya Mustansir says, “Not all parents have the skill to deal with this issue. The best that anyone can do is offer their unconditional love and create a safe environment.”

Though the concept of sex education is alien in our culture, today more than ever, schools need to accommodate in-house counsellors / psychologists who can talk to the students and unearth such cases and deal with them aptly. Clinical Psychologist at the NGO Sahil, Sana Anwar Gul says, “I cannot stress how vital it is for schools to have psychologists as counsellors. Anyone can listen and even empathise but only a trained psychologist will guide the child how to cope effectively.”

Thankfully there are a number of NGOs that cater to survivors of child sexual abuse and provides free legal aid and counselling. NGOs working on CSA have designed animation films and puppet shows to gently educate children regarding sexual abuse. These short skits and presentations also teach a child to make friends his own age, and never accept gifts from strangers.

Gul, who is part of the support system at Sahil, says, “Once the victims are identified we contact them and arrange in-house counselling sessions. However, if the incident has occurred in a far flung area, our teams travel to such children.”

Dr Ayesha, directress of the NGO Konpal which claims to aid and heal young victims of sexual abuse and related trauma, says that the Sindh Government Health Department finally announced in 2011 the formation of Hospital Child Protection Committees in every hospital.

“It is primarily the state’s responsibility to protect these children. At present eight major hospitals in Sindh have a committee comprising paediatricians, gynaecologists and psychologists to help cases of abuse. Six committees are operating in Karachi while two are working in interior Sindh.”

Sahil has also carried out training for parents on ‘child protection and parenting skills’ recognising that the biggest responsibility, undoubtedly, lies with parents. “The child has to be empowered by the family,” affirms Gul.

Teachers are the next care-givers thus Sahil also carries out Adolescent Health Training programmes where government school teachers have been trained to identify and handle such cases.

When children, suffering from sexual molestation, are brought to a psychologist, he tackles the issue with utmost sensitivity and then drafts the treatment plan for the patient depending on how severely he/she has been affected. “Every child copes differently,” comments Jumana Murtaza, a student of clinical psychology, “Thus, treatment plans are tailored accordingly. Recovery period may also vary from patient to patient.”

A lot of adults also seek psychological help, realising after years that they have been victims of sexual abuse when they were children. Mustansir explains, “Children who have been sexually abused in their childhood may suffer varying ill-effects but the most important one is their inability to develop intimate relationships. This may include difficulties with trust, fear of intimacy, establishing interpersonal boundaries and a tendency to get involved in abusive relationships.”